The Truth Behind the Gluten-Free Diet Part 1
To avoid making one very long post, due to all the Information out there on the history of gluten and how it's dietary use has changed In the last 76+ years, I will divide this into two blogs. Past and present. So here we go......
Gluten, one simple, short little word that has become the center of many debates and conversations over the last few years! But honestly what is GLUTEN?? A concise definition would say that Gluten is a family of proteins found in grains like wheat, rye, spelt, and barley. Gluten free diets have been around for many since the 1940's or earlier. However, at that time they were only used as a type of medical treatment, usually for those linked with Celiacs Disease. Over the last 3 or 4 decades research has been done regarding the gluten-free diet as a medical treatment for those with celiac, and as a choice for those without a sensitivity to gluten. . And interestingly enough it's been found that if people who are not gluten intolerant choose to eat a gluten-free way of life their health could actually be negatively impacted. We have also found that there is a direct link in gluten and inflammation levels in the body. Gluten is so much more than a simple little word.
Let's take a look back in history, the gluten free diet actually emerged in Europe in the 1940's as a medical treatment for children with celiac disease. Since that time it is estimated that MILLIONS of people around the world have removed some or all gluten and gluten containing foods from their diet. Many choose to do this on their own with no doctors recommendation. Until the 1970's a gluten free diet was most commonly seen in those who had celiac disease. Which is a disorder of the gut where the body is abnormally sensitive to gluten. During World War 2 in Europe, people, especially children, were becoming very malnourished because of lack of access to fruits, veggies and wheat. Obviously this was not ideal and weakened the health of many. But doctors noticed that it seemed to improve the health of those with Celiacs Disease. A Dutch pediatrician, Dr. Willem-Karen Dicke, discovered that children who had celiacs were suffering much less during the war than they did before the war. Before the war they had an adequate source of fruits, veggies and wheat. A disease, that before the World War 2, had about a 30% mortality rate was found to no longer be killing anyone. The only link that could be found was an overall lack of availability of wheat. In fact flour that may have included wheat pre-war, was being made with potato starch instead of wheat.
In 1941, Dr. Dicke wrote and published a paper about the effects of a wheat free diet that he had observed. Following the publication doctors started to link symptoms like bloating, diarrhea, constipation, gas, pain in the stomach and nausea, to gluten
Following the observations that Dr. Dicke documented in the early 1940's, there really was very little research on the topic for a few decades. Fast forward to the 1970's, when scientists began to find the first signs that celiacs disease could possibly be autoimmune rather than an allergy. The 1970's is when the research was done on how celiac develops (the pathogenesis of the disease). By the late 1970's many studies were published on the pathogenesis of the disease, that clearly linked celiac disease with other immunological disorders. Those studies would eventually prove that celiac disease is an autoimmune disorder. Meaning the immune system attacks it's own intestines when gluten enters the body. At this point scientist only believed that people with celiac disease could have a reaction to gluten, but the idea started to emerge that gluten could possibly impact the health of people without celiacs disease.
In the 1980's more research was being done that showed there was something called "non-celiac gluten sensitivity." The description of non-celiac gluten sensitivity was published in 1989 in the Journal of Gastroenterology. This specific publication discussed the stories of 8 women who complained of abdominal pain and chronic diarrhea, until they followed a gluten-free diet. These women had blood tests, and biopsies that were all negative for celiac disease. This remained a slightly confusing idea as it was showing new and different things that had been seen in previous research. It was decided at that time that those with non-celiac gluten sensitivity would be viewed as a medical condition that has the same symptoms of Celiac disease, without the immune system causing damage to their intestines. At this point in history they couldn't be completely positive that those with non-celiac gluten sensitivity are sensitive to gluten itself. They were looking at the fact that another protein in wheat could be the problem.
In the early 1990's celiac disease was considered extremely rare, almost nonexistent in the United States. Which was totally opposite of what was being seen in Europe at that same time. Celiacs disease was on the edge of being a total epidemic in Europe at that time. Dr. Alessio Fasano move from Naples to the Unites States in 1993 and he was shocked that the reported incidence of celiacs was so low in the US while it was so high in Europe. He found that this was partially due to the fact that research on celiac and gluten-free diets were almost exclusively being done in Europe, until Dr. Alessio moved to the US. Once he was settled in the US he began to do research to find out why the number of cases suffered so much between the US and Europe. What he found was that celiac disease was just as prevalent here in the US. The only difference was that it was basically being ignored here. He published an article about celiacs disease saying "Now you know, wherever you look for it, you find it, provided there are genes and environment triggers." Fasano would go on to publish a paper with more data, that lead to the change in the scientific community's viewpoint on Gluten in America.
Next time we will look at thoughts on Gluten now and how the gluten-free diet has become what seems more of a fad to many. So come back next week for part 2!